Novel wire‐free techniques for localization of impalpable breast lesions—A review of current options

Abstract

Localization methods for breast lesions including cancers have changed and advanced since their inception. Currently, the most widely used technique in the United Kingdom is the image‐guided hook wire localizer developed in the 1970s. It remains as the gold standard for localization of impalpable breast tumors. Besides its advantages, there are some disadvantages associated with this technique. In recent years, novel wire‐free techniques (eg, Magseed®, SCOUT®, and LOCalizer™) have been developed to not only localize impalpable breast lesions but also negate the disadvantages of wire localization. This article reviews the variety of techniques from their origins to the most recent advancements that are used to localize breast lesions. The future is heading toward non‐wire technology and wire localization may then be reserved for special cases.

Radioguided occult lesion localisation: A retrospective audit at a single tertiary academic breast unit

“…1,7,10 The wire-guided localisation (WGL) technique is the most widely used and preferred method of choice in many centres worldwide. 11,12,13 Despite its widespread use, WGL does have many reported disadvantages such as patient discomfort, technical difficulty and risk of complications. 7,14 The radioguided occult lesion localisation (ROLL) is an alternative technique using a radioactive tracer injected into or close to the lesion under radiographic guidance prior to surgery, where the localisation and removal of the lesion are aided by a handheld gamma probe.…”

Paramagnetic Localization—A Viable Option for Nonpalpable Breast Lesions

“…Guidewire localization has been the primary method used since it was first described in 1965. 1 Since then, several other localization techniques have been introduced and tested in clinical trials. 2 Pantiora et al 3 compared paramagnetic seeds vs guidewires for localization of nonpalpable breast cancers in a randomized clinical trial (RCT).…”

“…As breast-conserving surgery has become the primary method of surgical management for these cancers, surgeons have become more reliant on accurate localization techniques to correctly identify nonpalpable breast lesions. Guidewire localization has been the primary method used since it was first described in 1965 . Since then, several other localization techniques have been introduced and tested in clinical trials .…”

Cost-Effectiveness of Radar Localisation Versus Wire Localisation for Wide Local Excision of Non-palpable Breast Cancer

“…Wire localisation (WL) has been the “gold standard” technique since its introduction in the 1970s, being widely used, effective, and relatively affordable. 4 – 6 WL involves percutaneous insertion of a hooked wire into the lesion under imaging guidance. 2 , 5 There are however limitations with this method, including patient discomfort, wire transection, and migration.…”

“…Scheduling of WL usually is on the day of surgery to mitigate risk of migration, which can negatively impact theatre efficiency because of coupling of radiology and surgery scheduling. 6 …”